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Original Research Communication |
1 From the Centre for Nutrition and Food Safety, School of Biomedical and Health Sciences, University of Surrey, Guildford, United Kingdom.
2 Supported by a PhD studentship (to AF) from Research into Ageing, Help the Aged, and the Nestle Foundation. NRG was supported by a studentship from the Medical Research Council. The wheat gluten used was a gift from Tunnel Refineries, Greenwich, United Kingdom. 3 Dedicated to the memory of Peter Reeds and Bernard Beaufrere, each of whom made enormous contributions to our understanding of protein and amino acid requirements and directly participated in the development of the conceptual basis of the work described in this article. 4 Address reprint requests to DJ Millward, Center for Nutrition and Food Safety, School of Biomedical and Heath Sciences, University of Surrey, Guildford GU2 7XH, United Kingdom. E-mail: d.millward{at}surrey.ac.uk.
| ABSTRACT |
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Objective: We used a [1-13C]leucine balance, large single-meal protocol to estimate the utilization of wheat and the consequent lysine requirements.
Design: Wheat and milk utilization were compared in 5 adults infused for 9 h with L-[1-13C]leucine, in the postabsorptive (03 h) and postprandial (39 h) states after ingestion of a single meal of either milk (30.4 kJ/kg; 32% of energy as protein) or a mixture of wheat gluten and whole wheat (29.2 kJ; 26.7% of energy as protein). Premeal nitrogen balance was predicted from [1-13C]leucine oxidation and postmeal balance predicted from cumulative increased leucine oxidation, enabling evaluation of the metabolic demand for protein, the efficiency of postprandial protein utilization (PPU), and the requirements for wheat protein and lysine.
Results: Mean (±SD) PPU was 0.61 ± 0.03 and 0.93 ± 0.02 for wheat and milk (P
0.001), respectively, and the estimated average wheat-protein requirement (0.6 g·kg-1·d-1/PPU) was 0.98 ± 0.05 g·kg-1·d-1, indicating a lysine requirement of 18.3 ± 1.0 mg· kg-1·d-1.
Conclusions: Measured wheat utilization efficiency at 0.61 was considerably higher than the value predicted from wheat lysine intake and milk protein lysine deposition (ie, 0.222 ± 0.004). These results confirm our previous finding that lysine conservation allows wheat protein to be utilized more efficiently than expected and is consistent with a lysine requirement in fully adapted individuals of 19 mg·kg-1·d-1, as indicated by recalculated nitrogen balance data.
Key Words: Healthy adults protein quality milk wheat stable isotopes leucine balance nitrogen balance amino acid requirements
| INTRODUCTION |
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We recently reported studies of wheat-protein utilization using a novel [1-13C]leucine balance protocol (19) involving half-hourly feeding of small meals (2023). From measurements of [1-13C]leucine oxidation and balance, we predicted nitrogen balance enabling calculation of the metabolic demand for protein, the efficiency of postprandial protein utilization (PPU), and the apparent requirements for wheat protein and lysine. Wheat utilization was better than would be expected from theoretical considerations, confirming adaptive mechanisms of lysine conservation and allowing wheat to be utilized more efficiently than would be expected (6, 20). The lysine requirement calculated from wheat utilization was lower than most previous recent estimates but was similar to our recalculated (6) nitrogen balance data reported by Jones et al (16). However, frequent small meals might be used more efficiently than larger meals. For this reason, we used a [1-13C]leucine balance protocol adapted to enable study of protein utilization from a single large meal.
| SUBJECTS AND METHODS |
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Subjects
Five healthy subjects (4 men and 1woman) were studied on 2 occasions. The time between studies was 6 mo on average, but no changes in the diets or body weights of the subjects occurred during this period. The subject were aged 33.2 ± 12.8 y, weighed 66.5 ± 9.4 kg, and had a body mass index (in kg/m2) of 22.6 ± 2.4. Before the studies began, there had been no restrictions on activities of daily living; however, the subjects were encouraged to regulate their eating patterns (ie, 12 h of feeding and 12 h of fasting beginning at 0900) over the week before the study began. The study was approved by the University of Surrey ethical committee, and all subjects gave their informed consent after the nature of the protocol had been fully explained to them.
Infusion protocol
A schematic representation of the protocol is shown in Figure 2
. The subjects were asked to complete their last meal at 2100 at home and to report to the metabolic ward at 0730. At this time, intravenous L-[1-13C]leucine was infused as described previously (21, 24, 25) after baseline blood and expired breath samples (in duplicate) were collected and priming doses of NaH13CO2 (0.2 mg/kg) and L-[1-13C]leucine (99% 13C; MassTrace, Boston) were administered. The wheat studies were performed after the milk studies. After a review of the isotope need, it was decided that the tracer-infusion rate could be halved from 1 to 0.5 mg·kg-1·h-1 without sacrificing measurement precision. Thus, the priming doses of L-[1-13C]leucine were either 0.5 or 1 mg/kg and were followed immediately by a continuous infusion of L-[1-13C]leucine (either 0.5 or mg·kg-1·h-1) for 9 h, starting, in most cases at 0800 (11 h postabsorptive).
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4 mL) was collected at each time point and placed in lithium heparincontaining tubes, which were centrifuged immediately at 500 x g for 10 min at 4°C. The plasma was separated and dispensed equally into 2 tubes, which were stored at -20°C. Breath samples were collected for the analysis of expired 13CO2. Baseline samples were taken before the infusion started and then every 15 min during the third hour. After the meal was ingested at 3 h, breath samples were collected every 10 min for 2 h and then every 20 min for the remaining 4 h. Expired breath samples were collected in a urine collection bag with a one-way valve and tap and were then transferred, with the use of a 20-mL syringe, to a 20-mL evacuated tube (Vacutainer; Becton Dickinson, Franklin Lakes, NJ).
Carbon dioxide production rates were measured for 1 h during the postabsorptive period and continuously during the 6 h after the meal with the use of an indirect calorimeter with a ventilated tent system.
The meal was designed to provide 50% of the UK average daily protein intake and a relatively high protein-energy value. The meal contained 0.5 g protein/kg and provided 30 kJ/kg, ie, a protein-energy ratio of 30%. The fat content of the meal was kept as low as possible to maximize gastric emptying. Water was freely available throughout the study. Samples of the meals were taken and stored frozen before measurement of the leucine and nitrogen contents.
The milk-protein meal consisted of fresh skim milk and dissolved potato dextrose with low natural 13C enrichment. The meal was consumed within 510 min. The wheat-protein meal consisted of wheat gluten (Tunnel Refineries, Greenwich, United Kingdom), plain flour (Tesco London), and low naturally 13C-enriched potato dextrose (Avebe, Veendam, Holland). Wheat gluten was used to provide a high protein content in a small volume. It was fed as a dry fried pancake made from a dough prepared from an equal weight of gluten and plain flour with water and was served hot, accompanied by a drink containing dissolved potato starch with a small amount of sugar-free orange beverage. The meal was consumed within 1015 min. Prior feeding studies were performed to measure the extent to which background 13CO2 enrichment was influenced by either meal. Samples of each diet were analyzed for total nitrogen by Kjeldahl analysis. The macronutrient content of the 2 meals and protein intakes as leucine, nitrogen, and lysine are shown in Table 1
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Calculations
Leucine oxidation (O) was calculated, per minute, as follows:
![]() | (1) |
Cumulative leucine oxidation (µmol/kg) for the 6 h after the meal (Ocum) was calculated as follows:
![]() | (2) |
Leucine utilization was calculated, assuming that it was complete by 6 h after the meal:
![]() | (3) |
The efficiency of protein utilization, expressed in terms of nitrogen, PPUnitrogen, is defined as
![]() | (4) |
The conversion of leucine utilization to nitrogen utilization (19, 23) involves an assumed leucine-nitrogen ratio for tissue protein, as discussed below, and is necessary because of the differences between the leucine content of dietary and tissue proteins. Nitrogen intake was corrected for digestibilities, which were assumed to be 93% for wheat (28) and 100% for milk. No adjustment of meal leucine intake for tracer intake was made because tracer oxidation was assumed to be constant throughout the entire 9-h infusion; only excess leucine oxidation was used in the calculation.
Conversion factors for leucine-nitrogen and lysine-nitrogen ratios in meals and tissue protein and the metabolic demand
Leucine intakes were calculated from the measured nitrogen content of the milk and gluten meals and from the leucine-nitrogen ratios calculated from the reported ratio of leucine to total amino acids in bovine milk (29), manufacturers data for gluten (90% of the protein meal), and food-table values for whole wheat (10% of the protein) (30). Calculation of the leucine-nitrogen ratios assumed that reported values for aspartate and glutamate were derived from mixtures of their amides and the dicarboxylic amino acids in which the amides amounted to 10% and 40%, respectively, for aspartate and glutamate, as indicated by the amino acid sequences of the principal milk proteins in the gene sequence database (P Reeds, personal communication, 2002), with the same distribution for dicarboxylic acid and amide in wheat gluten. On this basis, the ratios of total amino acids to nitrogen were 7.31 and 7.45 for milk and wheat, respectively, and the leucine and lysine contents were 712 and 618 mg/g nitrogen for milk and 497 and 121 mg/g nitrogen for the wheat meal, respectively. These values represent amino acids after peptide hydrolysis (ie, more than the equivalent weight of protein because of the added water of hydrolysis) and are thus larger than the usually quoted values that convert nitrogen to protein, ie, that based on the mean ratios of peptide residue to nitrogen of 6.35 and 6.47 for milk and wheat, respectively. In calculating the lysine requirement from the average wheat-protein requirement, a value of 18.7 mg lysine/g wheat protein was used, ie, 121/6.47.
The leucine utilization of the milk and wheat protein was converted to nitrogen utilization by using a leucine-nitrogen conversion factor for tissue protein of 625 mg/g nitrogen, assuming values of 85.5 mg leucine/g protein and 7.31 for the ratio of total amino acid to nitrogen in tissue protein, the same as in milk protein, with a lysine-leucine ratio of 0.94. In fact, as is apparent in Figure 1
, utilized nitrogen provides for not only tissue gain (repletion of postabsorptive protein losses) but also for the oxidative component of obligatory and adaptive metabolic demands,
40% of the nitrogen utilization in the milk study, which may have a different leucine-nitrogen ratio. However, only the leucine-nitrogen ratio of the tissue protein gain can be predicted, ie, the weighted mean value for the labile protein mobilized and replaced during the diurnal cycle. This value is probably greater than the whole-body value, ie, 74 mg leucine/g protein (29), because this includes collagen at only 32 mg leucine/g protein, which is unlikely to be mobilized (as indicated from a nitrogen balance calculated from this whole-body value considerably in excess of the intake). The composition of the muscle contractile proteins is equivalent to 91 mg leucine/g protein (31), and the mean values for muscle and liver are 91 and 80 mg leucine/g protein (32). Previously (19), we used a beef muscle value of 82 mg leucine/g protein (30), but a better value can be derived from a 50:50 mixture of liver and muscle, which both participate (33), ie, 85.5 mg leucine/g protein. Lysine utilization was calculated as leucine utilization x 0.94 the lysine-leucine ratio of tissue protein identified as above.
Requirement for wheat protein and lysine and the predicted PPU of wheat protein
The apparent requirement (AR) for milk and wheat protein was calculated as follows:
![]() | (5) |
The estimated average requirement (EAR) for wheat protein and lysine was calculated as
![]() | (6) |
The EAR for lysine was calculated as shown:
![]() | (7) |
The predicted PPU of wheat protein was calculated as follows:
![]() | (8) |
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The predicted PPU is likely to be higher than the observed PPU to the extent that utilization is improved by 1) a decrease in the lysine oxidation component of the obligatory and adaptive metabolic demands in response to a low intake and 2) recycling of lysine from the free pool to allow, in effect, supplementation of dietary lysine. The adjustment of lysine intake and deposition for nitrogen intake is made to account for any minor difference in the size of the milk and wheat meals.
The data obtained in these studies allow nonsteady state analysis of leucine kinetics in terms of protein synthesis and proteolysis with the use of various modeling approaches. These data, however, do not add to the nutritional issue of estimating wheat protein utilization. It will be reported elsewhere.
Statistics
The results are expressed as means ± 1 SD. The influence of protein source on the time course of the postprandial responses was examined by analysis of variance (ANOVA) with repeated measures and post hoc testing at individual time points with Tukeys honestly significant difference test. The influence of dietary protein source on the various variables was examined with simple t tests. We used STATISTICA for WINDOWS (StatSoft, Tulsa, OK) for the statistical analysis. A P value
0.05 was assumed to indicate significance.
| RESULTS |
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The responses of plasma leucine to the 2 meals differed, and significant treatment x time interactions were observed: P = 0.185 for diet, P < 0.0001 for time, and P < 0001 for diet x time interactions (Figure 3
). After the milk-protein meal, leucine concentrations increased immediately to a peak after 1 h; the concentrations subsequently fell but remained elevated above the premeal value throughout the 6-h postmeal period. After the wheat-protein meal, the leucine concentration peak occurred much later (220 min postmeal), returning to baseline by 6 h postmeal (P
0.05 compared with premeal baseline values at 520 and 540 min).
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2 h postmeal (300 min); enrichment decreased after that, more slowly for wheat, reaching a maximum at
4 h after the meal (420 min). The carbon dioxide production rate also increased after the meals, reaching a peak earlier after the milk meal and returning to baseline but again reaching a peak much later after the wheat meal and remaining elevated for the 6 h postmeal. Leucine oxidation after the 2 meals displayed a pattern not significantly different from the changes in plasma leucine concentrations (Figure 5
0.05 compared with premeal baseline). After the wheat meal, a delayed increase in oxidation was observed, such that the peak rate was not reached until 3 h postmeal; nevertheless, oxidation returned to premeal baseline by 480 min (P
0.05 compared with premeal baseline). Significant diet x time interactions were observed: P = 0.108 for diet, P < 0.0001 for time, and P < 0.0001 for diet x time interactions.
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0.001) with the milk meal (0.93 ± 0.02) than with the wheat meal (0.61 ± 0.03). Assuming that wheat utilization is limited by lysine, the predicted value for wheat protein utilization in these subjects under the conditions of the experimental protocol (lysine intake/lysine deposition from milk) was 0.222 ± 0.004.
The metabolic demand and wheat protein and lysine requirements are shown in Table 3
. The metabolic demand calculated from premeal leucine balance (oxidation - tracer intake) was not significantly different between the 2 studies (0.77 ± 0.25 and 0.84 ± 0.18 g protein·kg-1·d-1 with the milk and wheat meals, respectively); therefore, a mean value of 0.81 ± 0.16 was used. Calculations with the use of the mean values for metabolic demand and PPUnitrogen for each protein source resulted in apparent protein requirements of 0.87 ± 0.17 and 1.31 ± 0.23 g·kg-1·d-1 for the milk and wheat meals, respectively. The estimated average protein requirement for wheat (0.6/PPUnitrogen) was 0.98 ± 0.05 g·kg-1·d-1, indicating a lysine requirement of 18.3 ± 1.0 mg protein·kg-1·d-1 on the basis of the lysine concentration in our wheat meals of 18.7 mg lysine/g protein.
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| DISCUSSION |
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0.05 at and after 460 min), resulting in a very small error in calculated PPU values. Even if leucine oxidation took an additional 3 h to return to baseline, this would result in an error in the estimation of the efficiency of milk-protein utilization of <2%. With the wheat meal, leucine oxidation peaked >3 h after the meal, which, together with the pattern of the other metabolic responses, indicated a delayed absorption of wheat protein, possibly a feature of the dry-fried wheat gluten pancake. Nevertheless, both leucine concentration and oxidation did return to baseline values by 6 h postmeal, with no significant change in the cumulative increased oxidation during the last 60 min. This suggests that absorption was complete.
A second assumption relates to the nature of the utilized dietary protein. We assume that meal leucine is utilized within the body for tissue protein deposition with an assumed leucinetissue nitrogen ratio to convert leucine balance to nitrogen balance as discussed above. In our previous low-protein, high-protein, steady state, small, frequent-meal protocol, leucine balance was measured at a time when only net protein deposition was occurring. Thus, the leucine-nitrogen ratio in tissue protein would entirely account for the actual leucine-nitrogen ratio of leucine utilization. However, as shown in Figure 1
, the meal protein provided for both the obligatory and adaptive oxidative losses (
42% of utilization at the premeal rate) and net protein deposition (
58% of utilization). Although a leucine-nitrogen factor can be identified to convert net leucine deposition into nitrogen, the composition of the oxidative losses component in the fed state is unknown, and no such factor can be calculated. Thus, conversion of utilized leucine (ie, intake - excess oxidation) to utilized nitrogen will be uncertain, although the leucine-nitrogen ratio of tissue protein will be the major determinant. Furthermore, leucine may be a major part of the adaptive component of the oxidative loss component of the metabolic demand, given the dietary sensitivity of the branched-chain dehydrogenase enzyme (26). Nevertheless a slightly lower true leucine-nitrogen ratio than we assumed may account for the slightly lower PPU values (0.93 and 0.61) than in our previous study (1.00 and 0.67; 19).
A potential error in PPUnitrogen relates to whether leucine gain involves unbalanced expansion of the free rather than the protein-bound leucine pool. After the wheat meal, the leucine concentration returned to baseline at 6 h, so no errors were involved. However, after the milk-protein meal, the leucine pool size was greater at the end of the test period. Because this amounted to only
3.7% of the meal leucine, with leucine oxidation returned to baseline, it might be assumed that this slight expansion of the free amino acid pool represents amino acids that would be available to meet the metabolic demand as either net protein deposition or any other metabolic fate. Alternatively, the slight elevation in concentration might represent surplus leucine in milk protein, still to be oxidized at a slightly elevated rate, that was not detectable. Importantly, in either case, no appreciable error was likely.
Finally, our design objective of isonitrogenous meals was not achieved. The nitrogen content of the wheat meal was 81% that of the milk meal. It might be assumed, therefore, that wheat-protein utilization was better at this lower intake, simply on the assumption of an improving efficiency of utilization with decreasing protein intakes, as indicated by previous nitrogen balance studies. However, our own studies failed to detect any influence of meal nitrogen content on the efficiency of milk-protein utilization (35).
As in our previous study (19), the efficiency of wheat utilization was much higher than would be predicted if wheat supplied all of the lysine needs for the required net protein deposition (ie, that observed in the same subjects with milk protein): ie, utilization of 26.4 mg lysine/kg in the 6 h after the meal, which only supplied 8.8 mg lysine/kg with 17.6 mg/kg unaccounted for. Part of this likely reflects the recycling of lysine released by net proteolysis during the postabsorptive phase into net protein deposition during feeding (9, 6, 12) by virtue of the relatively larger free intracellular pool size of lysine than of most other indispensable amino acids (36). The reduction in the free lysine pool in human muscle after feeding protein-free meals (36) is equivalent to 17.5 mg/kg lean tissue per 3 h, which is sufficient to entirely account for the deficit implied by the present studies. Thus, even though lysine oxidation adapts to the level of intake and varies throughout the day in meal-fed rats (37), it is not cleared from the free pool in human muscle as quickly as are leucine and other indispensable amino acids after a protein meal (36). Also, in lysine-deficient rats, a delayed lysine supplement (given 12 h after the remaining protein and amino acids) was utilized as effectively as was lysine given as part of a balanced meal (38). This was in contrast with tryptophan, which is only utilized when it is given within a balanced meal, presumably because it is rapidly oxidized if it cannot be used for net protein synthesis. Neither plasma nor intracellular lysine was measured in these experiments, so that the extent to which lysine recycling occurs requires further study. Clearly repeated feeding of the low-lysine diet would lower the free lysine concentration, limiting the amount available for recruitment into protein deposition. However, in our model, lysine oxidation and the amplitude of diurnal cycling would fall, reducing the requirement for lysine for net protein deposition.
A second mechanism that could have accounted for the better than expected utilization is an acute decrease in the adaptive metabolic demand component of lysine oxidation in response to the low-lysine meal. Lysine oxidation represents part of the 28 mg lysine utilized after the milk meal (
12 mg, ie, the lysine oxidation contribution to the postabsorptive loss; Figure 1
), so that an acute decrease in this component means that the intake was only having to provide for 16 mg as actual protein deposition, implying a much lower deficit.
A third mechanism involves the possibility of some de novo synthesis of lysine by colonic microflora utilizing urea nitrogen (39), as observed in infants (40)when urea salvage rates are high (41)and in adults (42). In those studies 15N was transferred from urea or ammonia to systemic lysine, implying de novo synthesis of lysine in nutritionally significant amounts (40, 42). Because we would expect relatively low rates of urea salvage in our subjects given their background protein intakes, in this case the de novo lysine supply may be less than is maximally possible. However, it may be more important in subjects chronically fed wheat protein.
As discussed previously (19), the implications of these values in the context of the current debate about lysine requirements and protein-quality evaluation in human adults can be examined from many perspectives.
First, nitrogen balance studies of wheat-protein utilization indicate a much lower value for net protein utilization (0.41 of that of egg protein; 28). However, nitrogen balance assays of protein quality are metabolically complex and differ from slope assays obtained in growing animals. This is because, within an adaptive model of protein homeostasis and requirements, in multilevel feeding trials with subjects adapted to each intake, the metabolic demand will increase with the intake so that the slope of the relation between nitrogen balance and nitrogen intake will markedly underestimate the true efficiency of any protein utilization (3, 35).
Second, the implied lysine requirement of 18.3 mg·kg-1·d-1 reported here and the value of 23.2 mg·kg-1·d-1 in our recent small-meal protocol study (19) is only an approximate estimate of the requirement and is likely to be greater than the physiologic minimum. This is because the adaptive metabolic-demand model of protein and amino acid requirements includes several responses to intake, which make prediction of protein utilization and quality difficult. Thus, in response to either a lower protein intake (12, 24) or a lower-quality protein intake (6), a decrease in the adaptive metabolic demand results in a decrease in postabsorptive losses and postprandial repletion, ie, a decrease in the amplitude of the diurnal cycle of protein gains and losses, reducing the metabolic demand for lysine for net protein deposition after a meal. Similarly, a reduction in the length of the postabsorptive period from the 12 h in our studies will also reduce postabsorptive losses and the need for net protein deposition after a meal. On this basis, the requirement of 19 mg·kg-1·d-1 indicated by the nitrogen balance data (6, 16) and a higher consequent PDCAA (protein digestibility corrected amino acid) score of wheat (0.74) would appear to be realistic.
In conclusion, the results of our studies show that in subjects adapted to generous protein and lysine intakes, the efficiency of wheat-protein utilization from a single large meal is higher than would be expected from recent reports of lysine requirements and higher than would be expected from theoretical predictions. The results are similar to those from our previous studies in subjects fed frequent small meals and imply that adaptive mechanisms of lysine conservation occur in subjects with typical mixed protein intakes. Our data indicate an average lysine requirement of 18.3 mg·kg-1·d-1, a value consistent with that indicated by the nitrogen balance data and lower than other more recently reported values.
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